Vardenafil and Hyoscine Butylbromide: Safe Together?

Vardenafil and Hyoscine Butylbromide: What You Need to Know

Published: 31 October 2026

If you've been prescribed vardenafil (generic Levitra) for erectile dysfunction and also use hyoscine butylbromide (commonly known as Buscopan) for stomach cramps or IBS, you may wonder whether vardenafil and hyoscine butylbromide can be taken together safely. The good news is that no major interaction between these two medicines is commonly reported in UK prescribing guidance. However, every medication you take—prescription or over-the-counter—must be declared during your consultation, so your prescriber or pharmacist can review your full medical history and ensure the combination is appropriate for you.

What is vardenafil and hyoscine butylbromide used for?

Vardenafil is a prescription medicine used to treat erectile dysfunction (ED) in adult men. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors, which work by relaxing blood vessels in the penis, allowing increased blood flow when you are sexually aroused [5]. Vardenafil is available in 5 mg, 10 mg, and 20 mg tablets and is usually taken about 25 to 60 minutes before sexual activity. The effect can last for several hours, but you should not take it more than once in 24 hours. Sexual stimulation is still needed for the medicine to work.

Hyoscine butylbromide (brand name Buscopan) is an antispasmodic medicine used to relieve stomach cramps, pain, and bloating caused by irritable bowel syndrome (IBS) or other gut conditions. It works by relaxing the muscles in the walls of the stomach and intestines. Hyoscine butylbromide is available over the counter from pharmacies and on prescription. It does not usually affect blood pressure or the cardiovascular system in the same way that some other medicines do, which is why it does not typically interact with PDE5 inhibitors like vardenafil.

Do vardenafil and hyoscine butylbromide interact with each other?

There is no well-documented or clinically significant interaction between vardenafil and hyoscine butylbromide reported in UK prescribing references such as the British National Formulary [5]. The two medicines work on different systems in the body: vardenafil affects blood flow to the penis by inhibiting an enzyme called PDE5, while hyoscine butylbromide acts on smooth muscle in the gut to reduce cramping. Because their mechanisms of action do not overlap, they are not expected to interfere with each other's effectiveness or safety when used at standard doses.

That said, it is still essential to tell your prescriber or pharmacist about all medicines you are taking, including over-the-counter products like Buscopan. This allows them to check for any individual factors—such as other health conditions or additional medicines—that might affect how vardenafil works for you. For example, if you are taking multiple medicines that can lower blood pressure or affect your heart, your prescriber will want to review the full picture before approving vardenafil [2].

Why you must declare all your medicines

Even when no major interaction is expected, your prescriber needs to know your complete medication list to ensure vardenafil is safe and suitable for you. Some medicines can raise or lower the levels of vardenafil in your blood, making it less effective or increasing the risk of side effects. Others may add to the blood-pressure-lowering effect of vardenafil, which can cause dizziness or fainting. By declaring everything—including vitamins, herbal supplements, and medicines bought without a prescription—you help your prescriber make the safest decision for your health.

What does your prescriber check before approving vardenafil?

When you request vardenafil through an online consultation at Cured Pharmacy, a UK-registered prescriber will review your medical history, current medicines, and overall health. They will check that you do not have any conditions that make vardenafil unsuitable, such as recent heart attack or stroke, unstable angina, severe heart failure, very low blood pressure, or a history of sudden vision loss (non-arteritic anterior ischaemic optic neuropathy, or NAION) [5]. They will also ensure you are not taking any medicines that must never be combined with PDE5 inhibitors.

The most important medicines to avoid with vardenafil are nitrates (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate), nicorandil, riociguat, and amyl or alkyl nitrites (poppers). Taking vardenafil with any of these can cause a dangerous drop in blood pressure [5]. You must also not take vardenafil alongside another PDE5 inhibitor (such as sildenafil, tadalafil, or avanafil). If you are on an alpha-blocker for prostate symptoms or high blood pressure (for example, doxazosin or tamsulosin), you can usually still take vardenafil, but you must be stable on the alpha-blocker and start on the lowest dose of vardenafil. Your prescriber will confirm this is safe for you [2][5].

Medicines that can affect vardenafil levels

Certain medicines can increase the amount of vardenafil in your bloodstream by slowing down how your liver breaks it down. These are called potent CYP3A4 inhibitors and include ritonavir, cobicistat (found in some HIV medicines), Paxlovid (used for COVID-19), ketoconazole, itraconazole, and clarithromycin [5]. If you are taking any of these, vardenafil may be contraindicated or require a much lower dose, and your prescriber will check the Summary of Product Characteristics (SmPC) to decide whether it is safe to prescribe.

On the other hand, medicines that speed up liver enzymes—such as rifampicin, carbamazepine, phenytoin, and the herbal remedy St John's wort—can reduce vardenafil levels, making it less effective [5]. If you are on any of these, your prescriber may discuss alternative ED treatments or adjust your dose. Grapefruit juice can also raise vardenafil levels and should be avoided. Heavy alcohol can worsen erectile dysfunction and add to the blood-pressure-lowering effect of vardenafil, so it is best to drink only in moderation [1][5].

Other blood-pressure medicines

If you take medicines for high blood pressure (such as amlodipine, ramipril, or bisoprolol), these can add to the blood-pressure-lowering effect of vardenafil, which may cause dizziness or light-headedness, especially when you stand up. This does not mean you cannot take vardenafil, but your prescriber will want to know about these medicines so they can start you on an appropriate dose and give you advice on managing any dizziness. Always stand up slowly from sitting or lying down, and avoid sudden changes in posture after taking vardenafil.

Practical advice for taking vardenafil and hyoscine butylbromide

If your prescriber approves vardenafil and you also use hyoscine butylbromide for stomach cramps, you can usually take both medicines as directed without concern. Hyoscine butylbromide is typically taken when you have symptoms—up to four times a day if needed—while vardenafil is taken on demand, about 25 to 60 minutes before you plan to have sex, and no more than once in 24 hours [5]. There is no need to separate the doses by a specific time interval, as the two medicines do not interfere with each other.

However, if you experience any unexpected symptoms—such as severe dizziness, fainting, chest pain, or an erection lasting more than four hours—seek medical help immediately. These are rare but serious side effects that require urgent attention [1][5]. If you develop new stomach symptoms or your IBS worsens, speak to your GP, as this may be unrelated to your ED treatment but still needs investigation. Always read the patient information leaflet that comes with each medicine, and do not exceed the recommended dose of either vardenafil or hyoscine butylbromide.

When to see your GP about erectile dysfunction

Erectile dysfunction is very common—it affects around half of men aged 40 to 70 to some degree [10]—and is often treatable. However, ED can sometimes be an early warning sign of underlying health problems, such as heart disease, diabetes, or high blood pressure [1][2]. If you are experiencing ED for the first time, or if it has worsened recently, it is important to see your GP for a full assessment. They can check for any underlying causes, review your current medicines (some can contribute to ED), and discuss lifestyle changes that may help, such as losing weight, stopping smoking, reducing alcohol, and increasing physical activity.

If your GP confirms that ED treatment is appropriate and you have no contraindications, you can then request a prescription through a registered online pharmacy like Cured Pharmacy. Our UK prescribers will review your consultation and, if suitable, issue a prescription for vardenafil or another PDE5 inhibitor. All our ED medicines are dispensed by our GPhC-registered pharmacy (GPhC 9012511) and delivered discreetly to your door. Remember, prescription ED treatments are only supplied after a clinical assessment by a UK-registered prescriber, and you should never buy vardenafil from unregulated websites, as counterfeit medicines can be dangerous.

Lifestyle and ED

Alongside medication, lifestyle changes can make a real difference to erectile function. Regular exercise improves blood flow and cardiovascular health, both of which are important for erections. Maintaining a healthy weight, eating a balanced diet, and managing stress can also help. If you smoke, stopping smoking is one of the most effective steps you can take, as smoking damages blood vessels and reduces blood flow to the penis [1][2]. Your GP or practice nurse can offer support with smoking cessation, weight management, and other healthy lifestyle changes.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 31 October 2026]
2. National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 31 October 2026]
3. Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 31 October 2026]
4. Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54–61. https://pubmed.ncbi.nlm.nih.gov/8254833/ [accessed 31 October 2026]

Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.

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